Department of Bioactivity and Food Analysis, Food Lipid Biomarkers and Health Group, Institute of Food Science Research, CIAL (CSIC-UAM), Universidad Autónoma de Madrid, Madrid, Spain.
Department of Biochemistry and Molecular Biology II, School of Pharmacy.
Adv Nutr. 2019 May 1;10(suppl_2):S164-S189. doi: 10.1093/advances/nmy099.
Milk and dairy products containing milk fat are major food sources of saturated fatty acids, which have been linked to increased risk of cardiovascular-related clinical outcomes such as cardiovascular disease (CVD), coronary heart disease (CHD), and stroke. Therefore, current recommendations by health authorities advise consumption of low-fat or fat-free milk. Today, these recommendations are seriously questioned by meta-analyses of both prospective cohort studies and randomized controlled trials (RCTs) reporting inconsistent results. The present study includes an overview of systematic reviews and meta-analyses of follow-up studies, an overview of meta-analyses involving RCTs, and an update on meta-analyses of RCTs (2013-2018) aiming to synthesize the evidence regarding the influence of dairy product consumption on the risk of major cardiovascular-related outcomes and how various doses of different dairy products affect the responses, as well as on selected biomarkers of cardiovascular disease risk, i.e., blood pressure and blood lipids. The search strategies for both designs were conducted in the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science databases from their inception to April 2018. From the 31 full-text articles retrieved for cohort studies, 17 met the eligibility criteria. The pooled risk ratio estimated for the association between the consumption of different dairy products at different dose-responses and cardiovascular outcomes (CVD, CHD, and stroke) showed a statistically significant negative association with RR values <1, or did not find evidence of significant association. The overview of 12 meta-analyses involving RCTs as well as the updated meta-analyses of RCTs did not result in significant changes on risk biomarkers such as systolic and diastolic blood pressure and total cholesterol and LDL cholesterol. Therefore, the present study states that the consumption of total dairy products, with either regular or low fat content, does not adversely affect the risk of CVD.
牛奶和含乳脂的乳制品是饱和脂肪酸的主要食物来源，而饱和脂肪酸与心血管相关临床结局（如心血管疾病、冠心病和中风）的风险增加有关。因此，健康机构目前的建议是食用低脂或无脂牛奶。然而，前瞻性队列研究和随机对照试验（RCT）的荟萃分析报告结果不一致，对这些建议提出了严重质疑。本研究包括对随访研究的系统评价和荟萃分析的概述、涉及 RCT 的荟萃分析概述，以及对 RCT 荟萃分析（2013-2018 年）的更新，旨在综合有关乳制品消费对主要心血管相关结局风险的影响的证据，以及不同剂量的不同乳制品如何影响反应，以及心血管疾病风险的选定生物标志物，即血压和血脂。这两种设计的检索策略均在 MEDLINE、EMBASE、Cochrane 对照试验中心注册库、Cochrane 系统评价数据库和 Web of Science 数据库中进行，检索时间从数据库建立到 2018 年 4 月。从检索到的 31 篇队列研究全文文章中，有 17 篇符合入选标准。不同剂量反应下不同乳制品消费与心血管结局（CVD、冠心病和中风）之间关联的汇总风险比估计值显示，RR 值<1 与统计学显著负相关，或未发现显著关联的证据。12 项涉及 RCT 的荟萃分析概述以及对 RCT 的更新荟萃分析并未导致风险生物标志物（如收缩压和舒张压、总胆固醇和 LDL 胆固醇）发生显著变化。因此，本研究表明，食用全脂乳制品，无论是常规脂肪含量还是低脂含量，都不会对 CVD 风险产生不利影响。
